Usual Dietary Intake and Adherence to Dietary Recommendations among Southwest American-Indian Youths at Risk of Type 2 Diabetes

Abstract

Background American Indians are disproportionately affected by obesity and diabetes, and American-Indian youths have the highest prevalence of obesity and diabetes among all ethnic groups in the USA. Objectives The purposes of this study were to assess the usual dietary intake in American-Indian youths who attended a wellness camp program; adherence to the Dietary Guidelines for Americans 2015–2020 (DGA) and to the Healthy People 2020 Objectives; and to compare pre- and postcamp reported diets. Methods A total of six 24-h dietary recalls were conducted in person with American-Indian youths (aged 10–15 y; n = 26) from 3 different Southwest tribes. Three recalls were conducted before the wellness camp, and 3 were conducted after the camp. A series of 2-factor ANOVA were conducted, using a mixed model, to compare the nutrition differences before and after the health camp using a statistical program, R. Results Adherence to federal dietary recommendations was low, with few of the youths meeting the DGA recommendations for fruits (15%, average serving 0.69 cup/d) and vegetables (35%, average serving 0.59 cup/d). All of the participants exceeded the DGA recommended limit on empty calories. Nutrient analysis of total fat intake showed a significant decrease in intake after the camp, F (1, 52) = 5.68, P = 0.02. Conclusions Diet is a modifiable risk factor for obesity and chronic diseases such as type 2 diabetes and needs to be an integral part of any healthy lifestyle intervention. The camp-based nutrition education had a positive effect on youths, as observed through the total fat intake decreasing after camp. To reinforce nutrition education, future nutrition education should involve parents, be delivered beyond the week at camp, and encompass social determinants of health and access to healthy foods.

Native Youth Participating in the Together on Diabetes 12-Month Home-Visiting Program Reported Improvements in Alternative Healthy Eating Index-2010 Diet Quality Domains Likely to Be Associated With Blood Pressure and Glycemic Control

“…12 Native youth who consume low amounts of potassium (found in fruits and vegetables) and high amounts of sodium (found in processed and convenience foods) have documented higher blood pressure, which is independently associated with diabetes risk. 13,14 Improved diet intake in this group has been associated with weight reduction, lower blood pressure, and increased insulin sensitivity. 15,16 Native youth have poor diet quality compared with national recommendations.…”

“…In one study, only 15% of Native youth aged 10 to 15 years were consuming the recommended daily serving of 1.5 to 2 cups of fruit and only 35% the recommended daily serving of 2 to 3 cups of vegetables. 14,17 Behavioral interventions aimed at improving diet have shown promise, but the majority of studies focus on individual components of diet intake. 15,16 Diet indices such as the Alternative Healthy Eating Index (AHEI-2010), which measure diet quality, have been used to quantify the overall effect of diet quality on diabetes and other chronic disease risk in adults.…”

Effects of a One-Week Intensive Wellness Camp on Dietary Behaviors among Southwest American Indian Youth

“…Description of the wellness summer camp has been summarized previously [15,16]. Briefly, AI youth from different tribes across Arizona were invited to participate in an annual one-week intensive residential camp from the years 2016 to 2019 and AI youth were followed up for two months after their participation in the camp.…”

“…As a particular emphasis, this one-week health intensive camp aims at promoting healthy lifestyle behaviors including healthful eating practices among high-risk AI youth [15]. Previously published results from the 2016 Wellness Camp showed that only 15% and 35% of participants met the Dietary Guidelines for Americans (DGA) recommendations for fruit and vegetable before the camp respectively, and after the camp, there was a significant reduction in total fat intake [16]. The current manuscript seeks to provide an update on the effectiveness of the Wellness Camp on dietary behaviors, including energy intake and intake of specific nutrient and food groups, combining data for the years 2016 through 2019.…”

Primary Disease Prevention for Southwest American Indian Families During the COVID-19 Pandemic: Camp in a Box

“…For example, 2019 American Indian campers (aged 10–15 years) reported: 1) 15.2% sometimes do not have enough to eat; 2) 39.4% reported drinking more than one sugar sweetened beverage per day; 3) 42.5% reported eating deep fried foods such as French fries or potato chips more than once per day; 4) 81.8% reported being physically active for less than 60 min per day during the past 7 days; 5) 51.2% reported playing video or computer games on an average school day for three or more hours per day; 6) 45.5% reported watching TV for three or more hours on an average school day; and, 7) 35.5% reported being bullied on school property during the last 12 months ( Gachupin et al, 2019a ). Based on 24-h dietary recall data, American Indian youth diets were high in calories, fat, and sodium, and low in fiber, calcium, and potassium ( Gachupin et al, 2019b ). Very few youth met the recommendations set forth in the Dietary Guidelines for Americans 2015–2020 ( U.S. Department of Health and Human Services and U.S. Department of Agriculture, 2015 ) for daily vegetable intake, and no participants met recommended limits on calories from solid fats and added sugars, which accounted for approximately 40% of total energy intake (primarily sugar sweetened beverages and snack foods).…”